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U.S. Not-For-Profit Health Care Rating Actions, April 2025

In April 2025, S&P Global Ratings maintained 27 ratings and took four positive rating actions on U.S. not-for-profit health care providers. In addition, we revised two outlooks favorably.

There were no downgrades or unfavorable outlook revisions in April.

We also assigned ratings to 14 new debt issuances for nine systems, four stand-alone hospitals, and one long-term-care facility.

The six rating actions and outlook revisions consisted of the following:

  • Four upgrades on three systems and one stand-alone hospital to the 'A' category and higher, of which three were related to mergers and acquisitions;
  • One outlook revision to positive from stable on a stand-alone hospital, based on a definitive agreement to merge with a higher-rated system; and
  • One outlook revision to stable from negative on a long-term-care facility.

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April 2025, U.S. not-for-profit health care rating actions
State Rating Outlook Entity Type Action Description

Adena Health System

OH A- Negative Stand-alone Maintained; New sale Credit quality consistent with existing rating

Blessing Hospital

IL A Stable Stand-alone Maintained Credit quality consistent with existing rating

Bon Secours Mercy Health*

MD A+ Stable System Maintained; New sale Credit quality consistent with existing rating

Brown University Health

RI BBB+ Stable System Maintained; New sale Credit quality consistent with existing rating

Cedars-Sinai Health System

CA AA- Stable System Maintained Credit quality consistent with existing rating

CommonSpirit Health

CO A- Stable System Maintained Credit quality consistent with existing rating

Community Foundation of Northwest Indiana

IN AA- Stable System Maintained Credit quality consistent with existing rating

Corewell Health

MI AA Stable System Maintained; New sale Credit quality consistent with existing rating

Corewell Health*

MI AA Stable System Maintained; New sale Credit quality consistent with existing rating

Dartmouth Health

NH A Stable System Maintained; New sale Credit quality consistent with existing rating

Denver Health and Hospital Authority

CO BBB Stable Stand-alone Maintained; New sale Credit quality consistent with existing rating

Doylestown Hospital

PA AA- Stable Stand-alone Upgrade Affiliation with University of Pennsylvania Health System and application of GRM criteria

Ector County Hospital District

TX BBB- Stable Stand-alone Maintained Credit quality consistent with existing rating

Greater Fairbanks Community Hospital Foundation

AK A Stable Stand-alone Maintained Credit quality consistent with existing rating

Henry County Health Care Authority

AL BB+ Stable Long-term care Favorable outlook revision Improved cash flows led to strengthened MADS coverage and expected breakeven results

Jennie Stuart Medical Center

KY BBB- Positive Stand-alone Favorable outlook revision Definitive agreement to affiliate with Deaconess Health System

Legacy Health

OR A Stable System Maintained Credit quality consistent with existing rating

Marshfield Clinic

WI A Stable System Upgrade Merger with Sanford Health and application of GRM criteria

Masonic Villages of the Grand Lodge of Pennsylvania

PA A Stable Long-term care Maintained; New sale Credit quality consistent with existing rating

Mayo Clinic*

MN AA Stable System Maintained; New sale Credit quality consistent with existing rating

Memorial Sloan Kettering Cancer Center

NY AA- Stable Stand-alone Maintained; New sale Credit quality consistent with existing rating

Meritus Health

MD A- Stable Stand-alone Maintained; New sale Credit quality consistent with existing rating

North Broward Hospital District

FL A+ Stable System Upgrade Trend of robust operating performance and improved balance sheet with meaningful tax support

Novant Health*

NC A+ Stable System Maintained; New sale Credit quality consistent with existing rating

Ochsner Health System

LA A Stable System Maintained; New sale Credit quality consistent with existing rating

OSF Healthcare System

IL A Stable System Maintained Credit quality consistent with existing rating

Providence St. Joseph Health

WA A Negative System Maintained Credit quality consistent with existing rating

Saint Lukes University Health Network

PA A- Stable System Maintained Credit quality consistent with existing rating

Salem Health

OR A+ Stable Stand-alone Maintained Credit quality consistent with existing rating

Temple University Health System

PA BBB Stable System Maintained Credit quality consistent with existing rating

University Health System

TN BBB Negative Stand-alone Maintained Credit quality consistent with existing rating

Virginia Mason Medical Center

WA A- Stable System Upgrade Note substitution with debt now secured by CommonSpirit Health

Wellstar Health System*

GA A+ Stable System Maintained; New sale Credit quality consistent with existing rating
*These actions relate solely to assignment of ratings on variable rate demand bonds (VRDBs) or commercial paper (Novant Health) following reviews completed earlier. MADS--Maximum annual debt service. GRM--Group Rating Methodology.

This report does not constitute a rating action.

Primary Credit Analyst:Blake C Fundingsland, Englewood + 1 (303) 721 4703;
blake.fundingsland@spglobal.com
Secondary Contacts:Cynthia S Keller, Augusta + 1 (212) 438 2035;
cynthia.keller@spglobal.com
Suzie R Desai, Chicago + 1 (312) 233 7046;
suzie.desai@spglobal.com
Amy He, New York +1 2124380381;
amy.he@spglobal.com

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